Provider Demographics
NPI:1255084240
Name:RAMBHARACK, NATASHA (NP)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:RAMBHARACK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 LYNNHAVEN DR STE A4
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1542
Mailing Address - Country:US
Mailing Address - Phone:757-496-5000
Mailing Address - Fax:
Practice Address - Street 1:2865 LYNNHAVEN DR STE A4
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1542
Practice Address - Country:US
Practice Address - Phone:757-496-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024183162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily